National Healthcare Quality and Disparities Report
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Topics
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
26 to 45 of 45 Research Studies DisplayedJafri SM, Vitous CA, Dossett LA
Surgeon attitudes and beliefs toward abdominal wall hernia repair in female patients of childbearing age.
This qualitative study examined surgeons’ thoughts on decision-making in repairing an abdominal wall hernia in a woman or girl of childbearing age.
AHRQ-funded; HS026030.
Citation: Jafri SM, Vitous CA, Dossett LA .
Surgeon attitudes and beliefs toward abdominal wall hernia repair in female patients of childbearing age.
JAMA Surg 2020 Jun;155(6):528-30. doi: 10.1001/jamasurg.2020.0099..
Keywords: Provider: Physician, Provider, Surgery, Women, Pregnancy, Decision Making
Gibson DC, Chou LN, Raji MA
Opioid prescribing trends in women following mastectomy or breast-conserving surgery before and after the 2014 federal reclassification of hydrocodone.
This study compares changes in opioid prescribing among surgical breast cancer patients following the 2014 federal reclassification of hydrocodone. Data from 2009 to 2017 was used from a large nationally representative commercial insurance health program. Women aged 18 years and older who were diagnosed with carcinoma in-situ or malignant breast cancer and received breast-conserving surgery or a mastectomy from 2010 to 2016 were included. Patients in 2015 or 2016 who had surgery were less likely to receive a greater than 1-day supply of opioid prescriptions or 30 days or more supply than in 2013. However, only in 2016 were surgical breast cancer patients less likely to receive a 90-day supply than in 2013.
AHRQ-funded; HS026133.
Citation: Gibson DC, Chou LN, Raji MA .
Opioid prescribing trends in women following mastectomy or breast-conserving surgery before and after the 2014 federal reclassification of hydrocodone.
Oncologist 2020 Apr;25(4):281-89. doi: 10.1634/theoncologist.2019-0758..
Keywords: Opioids, Medication, Surgery, Cancer: Breast Cancer, Cancer, Women
Laughlin-Tommaso SK, Lu D, Thomas L
Short-term quality of life after myomectomy for uterine fibroids from the COMPARE-UF fibroid registry.
Investigators compared women's perception of their short-term health-related quality of life measures and reported time to return to usual activities and return to work for different routes of myomectomy. Using data from the Comparing Options for Management: Patient-centered Results for Uterine Fibroids (COMPARE-UF) registry, and including abdominal and laparoscopic myomectomy procedures, they found that women who underwent myomectomy had substantial improvement in health-related quality of life, regardless of route of myomectomy; abdominal myomectomy was associated with a nearly 2-week longer time to return to work than laparoscopic myomectomy.
AHRQ-funded; HS023418.
Citation: Laughlin-Tommaso SK, Lu D, Thomas L .
Short-term quality of life after myomectomy for uterine fibroids from the COMPARE-UF fibroid registry.
Am J Obstet Gynecol 2020 Apr;222(4):345.e1-45.e22. doi: 10.1016/j.ajog.2019.09.052..
Keywords: Quality of Life, Women, Surgery, Patient-Centered Outcomes Research, Registries
Wallace K, Zhang S, Thomas L
Comparative effectiveness of hysterectomy versus myomectomy on one-year health-related quality of life in women with uterine fibroids.
The purpose of this prospective cohort study was to compare long-term health-related quality of life (HRQOL) 1 year after hysterectomy or myomectomy for treatment of uterine fibroids (UFs) and to determine whether route of procedure, race, or age affected improvements in HRQOL. The investigators concluded that HRQOL improved in all women 1 year after hysterectomy or myomectomy.
AHRQ-funded; HS023418.
Citation: Wallace K, Zhang S, Thomas L .
Comparative effectiveness of hysterectomy versus myomectomy on one-year health-related quality of life in women with uterine fibroids.
Fertil Steril 2020 Mar;113(3):618-26. doi: 10.1016/j.fertnstert.2019.10.028..
Keywords: Comparative Effectiveness, Women, Quality of Life, Surgery, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Xu X, Lin H, Wright JD
Association between power morcellation and mortality in women with unexpected uterine cancer undergoing hysterectomy or myomectomy.
Despite concerns that power morcellation may adversely affect prognosis of patients with occult uterine cancer, empirical evidence has been limited and inconclusive. In this study, the investigators aimed to determine whether uncontained power morcellation at the time of hysterectomy or myomectomy was associated with increased mortality risk in women with occult uterine cancer.
AHRQ-funded; HS024702.
Citation: Xu X, Lin H, Wright JD .
Association between power morcellation and mortality in women with unexpected uterine cancer undergoing hysterectomy or myomectomy.
J Clin Oncol 2019 Dec 10;37(35):3412-24. doi: 10.1200/jco.19.00562..
Keywords: Cancer, Mortality, Women, Surgery, Risk, Adverse Events
Grant MC, Gibbons MM, Ko CY
Evidence review conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery: focus on anesthesiology for gynecologic surgery.
This paper is an evidence review of enhanced recovery after surgery (ERAS) protocols for gynecologic surgery that will be used as part of AHRQ’s Safety Program for Improving Surgical Care and Recovery. This initiative was developed in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality. The authors conducted a literature review of the various anesthesia components which may influence outcomes and facilitate recovery after gynecological surgery. They included interventions for preoperative, intraoperative, and postoperative phases of care and then summarized the best available evidence for ERAS for gynecological surgery. The best evidence was summarized for recommendations to be used in the initiative.
Citation: Grant MC, Gibbons MM, Ko CY .
Evidence review conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery: focus on anesthesiology for gynecologic surgery.
AHRQ-funded; 233201500020I..
Keywords: Patient Safety, Surgery, Quality Improvement, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Women
Desai VB, Wright JD, Lin H
Laparoscopic hysterectomy route, resource use, and outcomes: change after power morcellation warning.
The purpose of this study was to examine changes in utilization of different types of laparoscopic hysterectomy, as well as their associated resource use and surgical outcomes, after the U.S. Food and Drug Administration (FDA) safety statement in April 2014 regarding power morcellation. They found rates of laparoscopic supracervical hysterectomy fell in association with power morcellation safety warnings, whereas rates of other laparoscopic hysterectomies continued to rise.
AHRQ-funded; HS024702.
Citation: Desai VB, Wright JD, Lin H .
Laparoscopic hysterectomy route, resource use, and outcomes: change after power morcellation warning.
Obstet Gynecol 2019 Aug;134(2):227-38. doi: 10.1097/aog.0000000000003375..
Keywords: Healthcare Utilization, Outcomes, Surgery, Women
Nicholson WK, Wegienka G, Zhang S
Short-term health-related quality of life after hysterectomy compared with myomectomy for symptomatic leiomyomas.
The objective of this study was to compare short-term health-related quality of life (HRQOL) 6-12 weeks after hysterectomy or myomectomy for the treatment of symptomatic leiomyomas. The investigators conducted a prospective comparative effectiveness analysis of data. They concluded that both hysterectomy and myomectomy were associated with substantial improvement in HRQOL at short-term follow-up, with small but statistically significant differences in symptom severity and certain subscales.
AHRQ-funded; HS023418.
Citation: Nicholson WK, Wegienka G, Zhang S .
Short-term health-related quality of life after hysterectomy compared with myomectomy for symptomatic leiomyomas.
Obstet Gynecol 2019 Aug;134(2):261-69. doi: 10.1097/aog.0000000000003354..
Keywords: Quality of Life, Surgery, Women, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes
Desai VB, Wright JD, Gross CP
Risk of unexpected uterine cancer in women undergoing myomectomy: a population-based study.
Data on the risk of unexpected uterine cancer specifically for women undergoing myomectomy are limited, as prior research has centered on hysterectomies (surgical removal of the uterus). In this correspondence, the authors discuss how they addressed this important gap using a large population-based sample.
AHRQ-funded; HS024702.
Citation: Desai VB, Wright JD, Gross CP .
Risk of unexpected uterine cancer in women undergoing myomectomy: a population-based study.
Eur J Obstet Gynecol Reprod Biol 2019 Jul;238:188-90. doi: 10.1016/j.ejogrb.2019.03.021..
Keywords: Cancer, Risk, Surgery, Women
Guglielminotti J, Landau R, Li. G
Adverse events and factors associated with potentially avoidable use of general anesthesia in cesarean deliveries.
Compared with neuraxial anesthesia, general anesthesia for cesarean delivery is associated with increased risk of maternal adverse events. Reducing avoidable general anesthetics for cesarean delivery may improve safety of obstetric anesthesia care. This study examined adverse events, trends, and factors associated with potentially avoidable general anesthetics for cesarean delivery. The investigators concluded that compared with neuraxial anesthesia, avoidable general anesthetics are associated with increased risk of adverse maternal outcomes.
AHRQ-funded; HS025787.
Citation: Guglielminotti J, Landau R, Li. G .
Adverse events and factors associated with potentially avoidable use of general anesthesia in cesarean deliveries.
Anesthesiology 2019 Jun;130(6):912-22. doi: 10.1097/aln.0000000000002629..
Keywords: Healthcare Cost and Utilization Project (HCUP), Labor and Delivery, Surgery, Pregnancy, Adverse Drug Events (ADE), Adverse Events, Women, Medication, Medication: Safety, Patient Safety, Maternal Care
Bossick AS, Sangha R, Olden H
Identifying what matters to hysterectomy patients: postsurgery perceptions, beliefs, and experiences.
This study collected data through structured focus groups with 24 post-hysterectomy women in order to identify Patient Centered Outcomes to employ in a subsequent cohort study of hysterectomy surgical approaches. According to the authors, the data suggested a need for increased education and empowerment in the decision making process, while expanding on information given for post-operative expectations and somatic changes that occur post-hysterectomy.
AHRQ-funded; HS022417.
Citation: Bossick AS, Sangha R, Olden H .
Identifying what matters to hysterectomy patients: postsurgery perceptions, beliefs, and experiences.
J Patient Cent Res Rev 2018;5(2):167-75. doi: 10.17294/2330-0698.1581..
Keywords: Patient Experience, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Surgery, Women
Borah BJ, Yao X, Laughlin-Tommaso SK
Comparative effectiveness of uterine leiomyoma procedures using a large insurance claims database.
The objective of this retrospective analysis of administrative claims from a large U.S. commercial insurance database, was to compare risk of reintervention, long-term clinical outcomes, and health care utilization among women who have bulk symptoms from leiomyoma and who underwent the following procedures: hysterectomy, myomectomy, uterine artery embolization, and magnetic resonance-guided, focused ultrasound surgery.
AHRQ-funded; HS023418.
Citation: Borah BJ, Yao X, Laughlin-Tommaso SK .
Comparative effectiveness of uterine leiomyoma procedures using a large insurance claims database.
Obstet Gynecol 2017 Nov;130(5):1047-56. doi: 10.1097/AOG.0000000000002331..
Keywords: Cancer, Comparative Effectiveness, Health Insurance, Outcomes, Patient-Centered Outcomes Research, Surgery, Women
Ross WT, Meister MR, Shepherd JP
Utilization of apical vaginal support procedures at time of inpatient hysterectomy performed for benign conditions: a national estimate.
The researchers sought to estimate trends and factors associated with use of apical support procedures at time of inpatient hysterectomy for benign indications in a large national database. Their study demonstrated that apical support procedures are not routinely performed at time of inpatient hysterectomy regardless of presence of prolapse diagnosis.
AHRQ-funded; HS019455.
Citation: Ross WT, Meister MR, Shepherd JP .
Utilization of apical vaginal support procedures at time of inpatient hysterectomy performed for benign conditions: a national estimate.
Am J Obstet Gynecol 2017 Oct;217(4):436.e1-36.e8. doi: 10.1016/j.ajog.2017.07.010.
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Keywords: Healthcare Utilization, Practice Patterns, Surgery, Women
Calderwood MS, Huang SS, Keller V
Variable case detection and many unreported cases of surgical-site infection following colon surgery and abdominal hysterectomy in a statewide validation.
This study assesses hospital surgical-site infection (SSI) identification and reporting following colon surgery and abdominal hysterectomy via a statewide external validation. The authors concluded that claims-based surveillance is a standardized approach that hospitals can use to augment traditional surveillance methods and health departments can use for external validation.
AHRQ-funded; HS021424.
Citation: Calderwood MS, Huang SS, Keller V .
Variable case detection and many unreported cases of surgical-site infection following colon surgery and abdominal hysterectomy in a statewide validation.
Infect Control Hosp Epidemiol 2017 Sep;38(9):1091-97. doi: 10.1017/ice.2017.134..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Injuries and Wounds, Patient Safety, Women, Adverse Events, Diagnostic Safety and Quality, Hospitals
Olsen MA, Nickel KB, Margenthaler JA
Increased risk of surgical site infection among breast-conserving surgery re-excisions.
The aim of this study was to determine the risk of surgical site infection (SSI) after primary breast-conserving surgery (BCS) versus re-excision among women with carcinoma in situ or invasive breast cancer. It found that the risk of SSI after re-excision remained significantly higher after accounting for multiple procedures within a woman.
AHRQ-funded; HS019713.
Citation: Olsen MA, Nickel KB, Margenthaler JA .
Increased risk of surgical site infection among breast-conserving surgery re-excisions.
Ann Surg Oncol 2015;22(6):2003-9. doi: 10.1245/s10434-014-4200-x..
Keywords: Surgery, Risk, Cancer: Breast Cancer, Cancer, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Patient Safety, Women
Jacoby VL, Jacoby A, Learman LA
Use of medical, surgical and complementary treatments among women with fibroids.
This study examined the use of medical management, uterus-preserving surgery, and complementary treatments among women with uterine fibroids. It found that uterus-preserving fibroid surgery is effective, but many symptomatic women can be successfully treated with nonsurgical management, including complementary and alternative therapy.
AHRQ-funded; HS011657; HS07373; HS09478.
Citation: Jacoby VL, Jacoby A, Learman LA .
Use of medical, surgical and complementary treatments among women with fibroids.
Eur J Obstet Gynecol Reprod Biol 2014 Nov;182:220-5. doi: 10.1016/j.ejogrb.2014.09.004..
Keywords: Care Management, Complementary and Alternative Medicine, Medication, Surgery, Treatments, Women
Wu JM, Matthews CA, Conover MM
Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery.
Using current, population-based surgical rates from 2007 to 2011, the researchers estimated the lifetime risk of stress urinary incontinence surgery, pelvic organ prolapse surgery or both to be 20 percent by the age of 80.
AHRQ-funded; HS017950.
Citation: Wu JM, Matthews CA, Conover MM .
Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery.
Obstet Gynecol. 2014 Jun;123(6):1201-6. doi: 10.1097/AOG.0000000000000286..
Keywords: Risk, Surgery, Women
Letourneau AR, Calderwood MS, Huang SS
Harnessing claims to improve detection of surgical site infections following hysterectomy and colorectal surgery.
The researchers conducted retrospective cohort studies at 2 academic medical centers, extending analyses of patients undergoing hysterectomy or colorectal surgery. They concluded that claims-enhanced surveillance can help to identify surgical site infections (SSIs) missed by routine surveillance, identifying nearly twice as many SSIs following hysterectomy and 4 times more SSIs following colorectal surgery.
AHRQ-funded; HS021424.
Citation: Letourneau AR, Calderwood MS, Huang SS .
Harnessing claims to improve detection of surgical site infections following hysterectomy and colorectal surgery.
Infect Control Hosp Epidemiol 2013 Dec;34(12):1321-3. doi: 10.1086/673975..
Keywords: Healthcare-Associated Infections (HAIs), Injuries and Wounds, Surgery, Patient Safety, Adverse Events, Women, Digestive Disease and Health
Suskind AM, Clemens JQ, Dunn RL
Effectiveness of mesh compared with nonmesh sling surgery in Medicare beneficiaries.
This study assessed the effectiveness of mesh compared to nonmesh slings in the surgical treatment of female incontinence. It found that overall rates of complications were similar for patients undergoing either mesh or nonmesh sling procedures. However, patients undergoing the nonmesh procedure were more likely to require a subsequent intervention for bladder outlet obstruction.
AHRQ-funded; HS018726.
Citation: Suskind AM, Clemens JQ, Dunn RL .
Effectiveness of mesh compared with nonmesh sling surgery in Medicare beneficiaries.
Obstet Gynecol. 2013 Sep;122(3):546-52. doi: 10.1097/AOG.0b013e31829e8543..
Keywords: Comparative Effectiveness, Elderly, Patient-Centered Outcomes Research, Surgery, Women, Outcomes, Medicare, Evidence-Based Practice
Jonsson Funk M, Visco AG, Weidner AC
Long-term outcomes of vaginal mesh versus native tissue repair for anterior vaginal wall prolapse.
This study estimated the rate of repeat surgery after vaginal mesh versus native tissue repair for anterior vaginal wall prolapse. The researchers found that the overall risk of any future surgery was higher in the women receiving mesh; however, native tissue and vaginal mesh surgery had similar 5-year risks for recurrent prolapse.
AHRQ-funded; HS017950
Citation: Jonsson Funk M, Visco AG, Weidner AC .
Long-term outcomes of vaginal mesh versus native tissue repair for anterior vaginal wall prolapse.
Int Urogynecol J. 2013 Aug;24(8):1279-85. doi: 10.1007/s00192-013-2043-9..
Keywords: Comparative Effectiveness, Surgery, Women, Outcomes, Risk